Article

Several tests have recently been developed to measure changes in
patient strength and functional outcomes in the intensive care unit (ICU). The
original Physical Function ICU Test (PFIT) demonstrates reliability and
sensitivity. The aims of this study were to further develop the
original PFIT, to derive an interval score (the PFIT-s), and to test the
clinimetric properties of the PFIT-s. DESIGN: A nested cohort study was
conducted. METHODS: One hundred forty-four and 116 participants performed the
PFIT at ICU admission and discharge, respectively. Original test components were
modified using principal component analysis. Rasch analysis examined the
unidimensionality of the PFIT, and an interval score was derived. Correlations
tested validity, and multiple regression analyses investigated predictive
ability. Responsiveness was assessed using the effect size index (ESI), and the
minimal clinically important difference (MCID) was calculated. RESULTS: The
shoulder lift component was removed. Unidimensionality of combined admission and
discharge PFIT-s scores was confirmed. The PFIT-s displayed moderate convergent
validity with the Timed "Up & Go" Test (r=-.60), the Six-Minute Walk Test
(r=.41), and the Medical Research Council (MRC) sum score (rho=.49). The ESI of
the PFIT-s was 0.82, and the MCID was 1.5 points (interval scale range=0-10). A
higher admission PFIT-s score was predictive of: an MRC score of >/=48, increased
likelihood of discharge home, reduced likelihood of discharge to inpatient
rehabilitation, and reduced acute care hospital length of stay. LIMITATIONS:
Scoring of sit-to-stand assistance required is subjective, and cadence cutpoints
used may not be generalizable. CONCLUSIONS: The PFIT-s is a safe and inexpensive
test of physical function with high clinical utility. It is valid, responsive to
change, and predictive of key outcomes. It is recommended that the PFIT-s be
adopted to test physical function in the ICU.

Langue : ANGLAIS